Provider Demographics
NPI:1043083215
Name:DOBBS, KAYLA MARIE (MT-BC, NMT, WMTR)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:DOBBS
Suffix:
Gender:F
Credentials:MT-BC, NMT, WMTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 N CASALOMA DR UNIT 90
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-7984
Mailing Address - Country:US
Mailing Address - Phone:859-760-0076
Mailing Address - Fax:
Practice Address - Street 1:245 N METRO DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8572
Practice Address - Country:US
Practice Address - Phone:920-903-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18103225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist